MEDICARE: SUZETTE WASVICK COUNSELING SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	2264	SD
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1992199988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUZETTE WASVICK COUNSELING SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 763
Second Line	:
City	:	HILL CITY
State	:	SD
Zip	:	57745-0763
Country	:	US
Telephone Number	:	605-390-8791
Fax Number	:

Provider Business Practice Location Address
First Line	:	2640 JACKSON BLVD STE 5
Second Line	:
City	:	RAPID CITY
State	:	SD
Zip	:	57702-3400
Country	:	US
Telephone Number	:	605-341-8647
Fax Number	:	605-341-8647

Authorized Official
Title or Position	:	OWNER
Name	:	SUZETTE WASVICK
Credential	:	LPC-MH
Telephone Number	:	605-390-8791

Provider Enumeration Date	:	03/27/2015
Last Update Date	:	10/09/2025

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